Online ISSN: 2515-8260

Elastography of the cervix for prediction of induction of labour.

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Dr. Sanjivani Wanjari*,Dr. Suresh PhatakDr. Deepti Shrivastava


Abstract: Background –Labour can be induced for various indications. This is done when it appears that benefits of induction outweigh its risk. Bishop score is the gold standard that is used to determine whether labour can be induced. However, the assessment of the cervix with digital examination is subjective and less reproducible. Elastography is an upcoming modality which is an ultrasound-based imaging technique used for assessing elasticity of tissues. It is based on the premise that softer tissues get more compressed than harder tissues when pressure is applied with ultrasound probe. Thereafter colour mapping is done depending on the gradient values of strain. Aim - to assess whether elastography findings of uterine cervix can be used to predict successful induction of labour. Objectives - 1) To examine the cervix by digital examination. 2) To determine the length of the cervix with the help of trans-vaginal ultrasound. 3) To perform strain elastography of the cervix. 4) To observe within how many hours labour starts after induction. Materials & methods – A prospective observational study will be done at AVBRH over a three years period from October 2018 to October 2021. Inclusion criteria - Pregnant women with gestation of 36-41 weeks, having no contraindication for labour induction, will be included in the study. Sampling procedure –Simple Random Sampling. Sample size – estimated sample size for study is 80 cases. Strain Elastography of the cervix will be performed before labour induction in the sample population and the outcome will be assessed. A score will be devised based on the colour mapping of elastography. ResultsUp till now we have had encouraging results. A colour map showing various colours from blue/purple through green/ yellow and then orange/red were noted. The colour red depicted a soft cervix that was easily inducible. On the other hand, purple colour denoted an unfavourable cervix. The colour score will soon be formulated and shared. Conclusion – Elastography may emerge as a new and upcoming method for determining favourability of the uterine cervix for labour induction based on a colour scoring system.

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